PubMed Health⌕ Search

Biomedical subjects

S Stenson

Publications and source records attributed to S Stenson.

17 recordsLinked to original sources

The influence of previous exposure to environmental mycobacteria on the interferon-gamma response to bacille Calmette-Guérin vaccination in southern England and northern Malawi.

We report a large study of the effect of BCG vaccination on the in vitro 6-day whole blood interferon-gamma (IFN-gamma) response to antigens from eight species of mycobacteria among schoolchildren in south-eastern England, where bacille Calmette-Guérin (BCG) vaccination is highly protective against pulmonary tuberculosis, and among young adults in northern Malawi, where BCG vaccination is not protective. In the UK children, BCG induced an appreciable increase in IFN-gamma response to antigens from most species of mycobacteria. The degree of change was linked to the relatedness of the species to Mycobacterium bovis BCG, and provides further evidence of the cross-reactivity of mycobacterial species in priming of the immune system. IFN-gamma responses to purified protein derivatives (PPDs) from M. tuberculosis and environmental mycobacteria were more prevalent in the Malawian than the UK group prior to vaccination; BCG vaccination increased the prevalence of responses to these PPDs in the UK group to a level similar to that in Malawi. There was no evidence that the vaccine-induced change in IFN-gamma response was dependent upon the magnitude of the initial response of the individual to environmental mycobacteria in the United Kingdom or in Malawi. These observations should assist the development and interpretation of human clinical trials of new vaccines against M. tuberculosis in areas of both low and high exposure to environmental mycobacteria.

Adolescent↗

Clinical survey of lens care in contact lens patients.

PURPOSE: Overall, contact lenses provide a safe and effective modality for vision correction. However, problems do occasionally arise. Up to 80% of contact lens complications can be traced to poor patient compliance with recommended lens care guidelines. We conducted a survey to evaluate the level of patient compliance in specific areas of lens care and maintenance and to assess patient knowledge of basic contact lens information. METHODS: Patients were asked to complete an anonymous 15 question survey that focused on lens care--specifically the use of contact lens cleaners, methods of disinfection, enzyme treatments, use of rewetting drops, and the frequency of follow-up exams. In addition, the survey included six true/false questions relating to contact lens care and safety. RESULTS: There were a total of 103 participants in the study. Approximately 24% of patients stated they never cleaned their lenses prior to disinfection, and 5% used saline solutions as their primary mode of disinfection. A sizable portion of those surveyed (43% of soft lens wearers and 71% of rigid gas permeable lens wearers) either never used enzyme cleaners or used them less than once a month. Seventy percent of patients either never used rewetting drops or used them less than once a day. Twenty-nine percent of patients consulted their eye care professionals every 2 years and 6% less often than every two years. Six questions assessed patient knowledge of contact lens care safety. Of a possible six out of six correct answers, the mean number of correct responses was 3.74. CONCLUSIONS: A sizable proportion of contact lens wearers do not adequately adhere to recommended contact lens care, and many have an inadequate understanding of contact lens care guidelines. Therefore, it is important that practitioners place more emphasis on patient education at the time of initial contact lens fitting and reinforce such instruction during follow-up visits.

Contact Lens Solutions↗

Traumatic brain injury crisis intervention and family therapy--management and outcome. Brain Injury Treatment and Research Group.

This article presents a model for crisis intervention and family therapy after traumatic brain injury. Our program, firmly rooted in object-relations theory and transactional analysis, included patients and family members (significant others) living within 100 miles from the University Hospital of Umeå. The effects of the interventions were gauged at one and two years after the trauma are presented in terms of agreement/disagreement between the patient and the significant other concerning inter- and intrapersonal relationships as well as through a short case presentation. As a conclusion of our study a point is made to expand the scope of intervention to include also other segments of the social network of the patient.

Adult↗

Superior limbic keratoconjunctivitis associated with soft contact lens wear.

Four cosmetic soft contact lens wearers experienced lens intolerance and mild irritative symptoms. All four displayed changes suggestive of those seen in superior limbic keratoconjunctivitis with papillary hypertrophy and inflammation of the upper tarsus, superior tarsal and bulbar conjunctival fluorescein staining, superior limbal hypertrophy, and upper corneal punctate staining. Three of the four conditions resolved with discontinuance of lens wear alone; the fourth improved, but there was persistence of mild upper bulbar conjunctival and corneal staining for two years. No common causative contact lens-related factors were obvious in the four. Three of the patients were subsequently able to resume lens wear on a modified basis.

Adult↗

Laboratory studies in chronic conjunctivitis.

Conjunctival cultures and scrapings for cytological examination were done in 852 cases of chronic conjunctivitis. Bacteria were recovered in 464. Of these, Staphylococcus sp were isolated in 91%; their etiologic importance over normal flora is questionable. Important cytological findings included atypical epithelium (three cases), Halberstaedter-Prowazek inclusion bodies (two), and eosinophils (104). Epithelial degenerative changes were common (585 cases). Crystals (105) and microorganisms (283) were other frequent findings. Active infection seems to be an uncommon cause of chronic conjunctivitis. Cultures are important in avoiding unnecessary antibiotic therapy when no organism is present. Cytological examination can be a helpful diagnostic adjunct in selected cases and is to be recommended especially in chronic follicular conjunctivitis, possible drug toxicity or allergy, dry eye states, and other atypical clinical presentations.

Bacteria↗

Ulcerative keratitis. Survey of 30 years' laboratory experience.

During a 30-year period, causative organisms were identified on Gram's stain and culture in 547 of 677 cases of infectious corneal ulcers. Even if no organisms were seen on Gram's stain, culture results were often positive. Staphylococcus was the most common isolate; Moraxella, Pseudomonas, and Streptococcus pneumoniae were the next most frequent pathogens. Only 1% of cases were fungal. Of some help in identifying the causative organism were locations, presence or absence of hypopyon, and perforation of the ulcer. Most marginal lesions were a result of staphylococcal infection; central lesions were more likely to be Gram-negative ulcers. Fungal ulcers were identified by laboratory workup and not by clinical characteristics. Moraxella infection was observed almost exclusively in malnourished patients. Pseudomnas ulcers were often seen in patients with large body burns or patients receiving respiratory assistance. Gentamicin and neomycin were the most effective treatments.

Adolescent↗

Laboratory studies in acute conjunctivitis.

In 84% of 700 consecutive cases of untreated acute conjunctivitis subjected to conjunctival cultures and scrapings, a presumptive etiologic diagnosis could be made based on standard microbiologic and cytologic criteria. Of these 583 cases, 264 were bacterial, 245 were viral, 51 were allergic, and 17 were chlamydial. In 75% of the cases, clinical impressions were consistent with laboratory findings. On the basis of these results, laboratory workup is recommended in (1) follicular conjunctivitis to differentiate viral from chlamydial processes, (2) purulent conjunctivitis to identify pathogens and decide on appropriate antimicrobial therapy based on sensitivity data, and (3) those cases in which the clinical picture is not sufficiently distinctive to suggest an etiologic diagnosis.

Acute Disease↗

Bilateral endogenous necrotizing scleritis due to Aspergillus oryzae.

A case of bilateral necrotizing scleritis due to Aspergillus oryzae is reported. The patient was a former addict of intravenous narcotics treated five years previously for meningitis due to the same organism. A seeding focus in the thoracic spine was eventually found. The patient responded well to combined local and systemic therapy with amphotericin B, flucytosine, and natamycin. This represents, to the best of our knowledge, both the first reported case of ocular disease due to this species of Aspergillus and of isolated scleral, nonintraocular involvement in endogenous oculomycosis.

Adolescent↗

Ocular findings in xeroderma pigmentosum: report of two cases.

Xeroderma pigmentosum is a hereditary precancerous dermatosis caused by a defect in DNA repair-replication after damage induced by exposure to ultraviolet light. The clinical course is characterized by progressive hyperpigmentation and atrophy of the skin with tumorigenesis, basal and squamous cell carcinomas being most common. Ocular involvement occurs in up to 80% of cases, with recurrent infection, neoplasia, and atrophy of the lids, conjunctiva, and cornea the most common findings. Two cases of xeroderma pigmentosum and their ophthalmic findings are described.

Adult↗

Focal giant papillary conjunctivitis from retained contact lenses.

Three cases of retained contact lenses leading to focal papillary conjunctivitis of the upper lids reminiscent of the more diffuse changes of lens or suture-induced giant papillary conjunctivitis are reported. One silicone and two cabufocon lenses were responsible. Corneal changes occurred in two of the three cases. Secondary infection with Staphylococcus aureus was found in one patient. In two, conjunctival cytology suggested a hypersensitivity mechanism. In all three patients the simple removal of the retained lens was sufficient to reverse pathology. The focal nature of the papillary changes observed in these patients as well as in those cases occurring post-operatively from exposed suture edges would point towards an important direct mechanical etiologic factor in addition to the proposed hypersensitivity basis for the similar diffuse upper lid papillary hypertrophy characteristic of giant papillary conjunctivitis.

Adult↗

Ocular findings in mycosis fungoides.

Thirty consecutive patients with biopsy-proved mycosis fungoides were examined ophthalmologically. Specific ocular changes, judged directly related to the mycosis fungoides, were found in 11 of the 30 subjects, usually in the late plaque or tumor stages of the disease. Tumors, especially involving the lids, were the most common ophthalmic finding. Keratitis, uveitis, and optic atrophy were also described. A review of the literature is given, and changes found in patients in this series correlate well with ophthalmic findings presented in diverse isolated case reports. It seems that the frequency of ophthalmic pathologic findings in mycosis fungoides is much more common than previously assumed.

Aged↗

Adult inclusion conjunctivitis. Clinical characteristics and corneal changes.

Twenty-five consecutive cases of adult inclusion conjunctivitis were studied. Diagnosis was based on the finding of typical Halberstaedter-Prowazek inclusion bodies on conjunctival scrapings. Corneal involvement was common (20/25 patients); most frequent was superficial epithelial keratitis (15/25). Other changes seen included subepithelial nummular keratitis (6/25), marginal keratitis (2/25), (4/25). There seemed to be a predilection for involvement of the upper half of the cornea. Conjunctival scarring occurred in one patient only. Associated genitourinary symptoms were spontaneously reported in three patients only; however, on careful questioning, an additional 12 patients were found to have a history of urethritis or cervicitis. A comparison with viral follicular conjunctivitis is made. The location and pattern of keratopathy, associated genitourinary complaints, mucopurulent nature of discharge, and lack of response to standard topical therapy would seem to suggest chlamydial cause. Conjunctival scrapings are very helpful in differential diagnosis between viral and chlamydial conjunctivitis.

Adolescent↗

Conjunctivitis in the newborn: observations on incidence, cause, and prophylaxis.

One hundred seventy-one cases of neonatal conjunctivitis seen at Bellevue Hospital during the period 1950--1976 were reviewed. An overall incidence of 3.0 cases per 1,000 live births was found. A comparison of the rates of neonatal conjunctivitis with silver nitrate and tetracycline prophylaxis revealed a 100% increase in the rate overall, as well as the rate of gonococcal conjunctivitis with tetracycline. Using conjunctival cultures and cytology, a diagnosis could be established in 73% of the cases, with 41% being bacterial and 32% chlamydial. Staphylococcus was the single most common organism recovered; gonococcus was relatively rare.

Bacterial Infections↗

Contamination in McCarey-Kaufman stored keratoplasty donor material.

One hundred consecutive donor corneas which had been preserved in McCarey-Kaufman medium and used in actual keratoplasties were studied. The residual medium and button remnants were cultured for bacterial and fungal growth. Coagulase-positive staphylococci were recovered in three cases, coagulase-negative staphylococcus in one and Rhodotorula sp. in another; no associated postoperative infections were reported, although one patient was regrafted 48 hours after the initial keratoplasty for "graft decompensation"--the initial button was not submitted for reculture. One additional specimen was processed. A cracked vial with clear contained fluid was held for culture; Pseudomonas cepacia was grown from the fluid. Other samples in undamaged vials from the same lot did not show contamination.

Anti-Bacterial Agents↗